---
[ ARCHIVE ](https://www.citywatchla.com/archive)
# Horror Tales from Insurance Land
June 24 2011
Written by Judy Dugan.
[](https://www.addtoany.com/share)
***POLITICS OF HEALTH*** - I'm sure California Insurance Commissioner Dave Jones knew what he was in for when he called together a few dozen consumer-focused organizations to talk about their issues with insurance--health, auto, home, long term care and more.
The stories filled a day, and could have gone on for days more--of payment and care denied, policies that turn out not to be what was advertised.
Maybe most shocking: An insurance company ordering a family in the Bay Area to fly their autistic toddler to Los Angeles for daily treatment if they wanted to stay in-network.
Jones and all of his top staff were there, responsive and looking for ways to use these stories for enforcement against illegal practices and to encourage insurers to treat consumers better voluntarily.
The Insurance Department got an earful. Here's a sampling:
• Surprise, You're Canceled! A guy needs major surgery and calls his insurance company to get approval. I's granted and he's already in the hospital, already had some treatment, when the hospital office calls the insurer just to triple check. At that point, the insurer says the policy was canceled weeks ago for failure to pay a $7 a month increase on the policy--even though the patient was never notified of the increase. Result: hundreds of thousands of dollars of unpaid medical care, and the patient is uninsured.
This cancellation tactic may be insurers' substitute for rescinding a policy when a patient gets sick, citing some error on his or her insurance application. That tactic been strictly limited by the federal health reforms. So now a $7 dispute is enough to get a policy canceled for "nonpayment"--if the patient is going to cost the insurer some money. If you've ever heard of a healthy person being canceled over a $7 missed payment, let us know ([click here](http://www.consumerwatchdog.org/file-complaint)).
• Find the Doctor In the Haystack: People seeking mental health care are, under the law, supposed to get the same level of treatment as for physical ailments. But the reality, told over and over at the meeting, is that insurers sometimes have zero in-network doctors for tough, expensive diagnoses like autism. It's against the law but hard to prove, since the insurer may hand the family a list of 100 psychologists, expecting them to call the list until they find--or don't find--one that treats children, and also treats what their child has.
• "Survivor" Getting any care, especially for tough diseases like autism, means endless delays, "lost" paperwork, repeated denials for the same discredited reason ("it's experimental." "It's education, not medical care.") The most persistent and knowledgeable eventually get treatment. But each refusal makes more families give up. It's "Survivor" with real lives at stake.
• Guess What's Covered? Homeowner insurance doesn't have the drama of health insurance. But when a family's biggest investment takes a hit from fire, water or other destruction, it's not small potatoes. Advocates at the meeting said insurers are steadily and stealthily cutting back on what's covered, especially water damage, and writing in other exceptions that thin out coverage. But homeowners can't compare policies because insurers won't show you the details until you buy.
Jones can't fix all these things quickly, and he's not the type to use a sledgehammer if he doesn't have to. But he's paying attention to the groups who can be his department's boots on the ground, and has made it clear that he won't hesitate to go after rulebreakers when he's got the proof.
(Judy Dugan blogs at [consumerwatchdog.com](http://www.consumerwatchdog.com) where this column was first posted.) –cw
Tags: Dave Jones, California Insurance Commission, insurance
CityWatch
Vol 9 Issue 50
Pub: June 24, 2011
[  ](https://www.citywatchla.com/component/banners/click/107 "LA DWP | Save $4K, Green | Priority Ad")
[  ](https://www.citywatchla.com/component/banners/click/98 "Donna Tryfman - HS1-1")
[  ](https://www.citywatchla.com/component/banners/click/82 "LA DWP #2 (Power Savers)")
[  ](https://www.citywatchla.com/component/banners/click/111 "David DeJute Campaign")
[  ](https://www.citywatchla.com/component/banners/click/97 "Home - LA DWP #2 (Pay Water Bill Help)")
[  ](https://www.citywatchla.com/component/banners/click/112 "Anna Reitano Vertical R. Col")
## Get The News In Your Email Inbox Mondays & Thursdays
Website
[  ](https://www.citywatchla.com/component/banners/click/110 "Something You Should Know")
[  ](https://www.citywatchla.com/component/banners/click/113 "Rhonda Haymon campaign")
---
## Featured CityWatch Stories
[  ](https://www.citywatchla.com/los-angeles/33444-lahsa-is-gone-but-the-homeless-industrial-complex-lives-on)
### [LAHSA Is Gone, but the Homeless-Industrial-Complex Lives On](https://www.citywatchla.com/los-angeles/33444-lahsa-is-gone-but-the-homeless-industrial-complex-lives-on)
HOMELESSNESS - Los Angeles’s homelessness program is in complete disarray, undermined by systemic gridlock, structural…
[  ](https://www.citywatchla.com/housing/33413-with-national-implications-corporate-landlords-take-aim-at-three-pro-rent-control-campaigns-in-california)
### [With National Implications, Corporate Landlords Take Aim at Three Pro-Rent Control Campaigns in California](https://www.citywatchla.com/housing/33413-with-national-implications-corporate-landlords-take-aim-at-three-pro-rent-control-campaigns-in-california)
HOUSING IS A HUMAN RIGHT - Corporate landlords and their high-powered lobbying group, the California Apartment Associat…
[  ](https://www.citywatchla.com/neighborhood-politics/33434-karen-bass-trails-in-reelection-race-can-she-turn-it-around)
### [Karen Bass Trails in Reelection Race — Can She Turn It Around?](https://www.citywatchla.com/neighborhood-politics/33434-karen-bass-trails-in-reelection-race-can-she-turn-it-around)
WESTSIDE - As of September 27, 2026, Karen Bass is in a substantially weaker position than she was entering the June pr…
[  ](https://www.citywatchla.com/finance/33442-the-settlement-bill-nobody-is-managing-inside-los-angeles-countys-sheriff-litigation-tab)
### [The Settlement Bill Nobody Is Managing — Inside Los Angeles County's Sheriff Litigation Tab](https://www.citywatchla.com/finance/33442-the-settlement-bill-nobody-is-managing-inside-los-angeles-countys-sheriff-litigation-tab)
THE NAVARRO REPORT - Last month, the Los Angeles County Board of Supervisors approved a $12.5 million settlement over t…
[  ](https://www.citywatchla.com/voices/33431-the-unflinching-daily-horror-in-the-west-bank)
### [The Unflinching Daily Horror In The West Bank](https://www.citywatchla.com/voices/33431-the-unflinching-daily-horror-in-the-west-bank)
THE WEST BANK - More often than not, I find myself at a loss for words to convey Israel’s genocide in Gaza and the rele…
---
## [ ARCHIVE ](https://www.citywatchla.com/archive)
[  ](https://www.citywatchla.com/archive/15339-early-intervention-and-jobs-are-key-to-stemming-chronic-homelessness-in-los-angeles)### [Early Intervention and Jobs are Key to Stemming Chronic Homelessness in Los Angeles](https://www.citywatchla.com/archive/15339-early-intervention-and-jobs-are-key-to-stemming-chronic-homelessness-in-los-angeles)
### [Tucker Carlson and Gay Rightwinger Blame California Wildfires On Hiring LGBTQ People](https://www.citywatchla.com/archive/18755-tucker-carlson-and-gay-rightwinger-blame-california-wildfires-on-hiring-lgbtq-people)
### [Anti-LGBTQ Veep Just Can’t Stop Talking about Mayor Pete](https://www.citywatchla.com/archive/17690-anti-lgbtq-veep-just-can-t-stop-talking-about-mayor-pete)
[  ](https://www.citywatchla.com/archive/15316-news-pulse-corrupt-system-reason-for-not-voting-in-2018-majority-wants-more-than-two-parties)### [NEWS PULSE: ‘Corrupt System’ Reason for Not Voting in 2018 … Majority Wants More Than Two Parties](https://www.citywatchla.com/archive/15316-news-pulse-corrupt-system-reason-for-not-voting-in-2018-majority-wants-more-than-two-parties)
[  ](https://www.citywatchla.com/archive/10245-dead-dog-set-on-fire-sparks-fears-for-strays-in-los-angeles)### [Dead Dog Set on Fire … Sparks Fears for Strays in Los Angeles](https://www.citywatchla.com/archive/10245-dead-dog-set-on-fire-sparks-fears-for-strays-in-los-angeles)